{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:40:05Z","timestamp":1791852005237,"version":"4.3.4"},"reference-count":21,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"unspecified","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1049023X25000251_as1\"><jats:title>Introduction:<\/jats:title><jats:p>Non-traumatic back pain commonly leads people to seek health care from paramedics via triple-zero (emergency phone number in Australia), yet the management approaches by providers of ambulance services remain unclear.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X25000251_as2\"><jats:title>Study Objectives:<\/jats:title><jats:p>This study aims to investigate paramedic management of non-traumatic back pain in New South Wales (NSW), Australia, including the call characteristics, provisional diagnoses, and the clinical care being delivered by paramedics.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X25000251_as3\"><jats:title>Methods:<\/jats:title><jats:p>This study is a retrospective analysis of NSW Ambulance computer-aided dispatch and electronic medical records from January 1, 2017 through December 31, 2022. Adults who sought ambulance service with a chief complaint of back pain, were triaged as non-traumatic back pain, and subsequently received treatment by paramedics were included. Multivariable logistic regression models were used to explore factors associated with primary outcomes; ambulance transport, opioid use, and use of medication combinations were reported as odds ratios (ORs).<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X25000251_as4\"><jats:title>Results:<\/jats:title><jats:p>There were 73,128 calls to NSW Ambulance with a chief complaint of back pain that were triaged as non-traumatic back pain. Of these, 54,444 (74.4%) were diagnosed with spinal pain, of which 52,825 (97.1%) were categorized by the paramedic as back or neck pain, 1,573 (2.9%) as lumbar radicular pain, and 46 (0.1%) as serious spinal pathology. Eight out of ten patients with spinal pain were transported to emergency departments. The medicine most\u00a0administered by a paramedic was an opioid (37.4% of patients with spinal pain). Older patients (OR = 1.36; 95% CI, 1.30 to 1.44) were more likely to be transported to an emergency department. Patients with moderate (OR = 4.39; 95% CI, 4.00 to 4.84) and severe pain (OR = 18.90; 95% CI, 17.18 to 20.79) were more likely to be administered an opioid.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X25000251_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>Paramedic management of non-traumatic back pain in NSW typically results in the administration of an opioid and transport to an emergency department.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1049023x25000251","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T07:37:21Z","timestamp":1744011441000},"page":"77-85","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Paramedic Management of Non-Traumatic Back Pain in a Large Australian Ambulance Service: A Retrospective Study"],"prefix":"10.1017","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1267-3782","authenticated-orcid":false,"given":"Simon P.","family":"Vella","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5263-2219","authenticated-orcid":false,"given":"Chathurani","family":"Sigera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason C.","family":"Bendall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3875-0061","authenticated-orcid":false,"given":"Paul","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1258-5125","authenticated-orcid":false,"given":"Christina","family":"Abdel-Shaheed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2184-8409","authenticated-orcid":false,"given":"Michael S.","family":"Swain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1628-7857","authenticated-orcid":false,"given":"Chris G.","family":"Maher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8544-0448","authenticated-orcid":false,"given":"Gustavo C.","family":"Machado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"key":"S1049023X25000251_ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5673-2"},{"key":"S1049023X25000251_ref17","unstructured":"17. International Academies of Emergency Dispatch. The Medical Priority Dispatch System. IAED Website. https:\/\/www.emergencydispatch.org\/what-we-do\/emergency-priority-dispatch-system\/medical-protocol. Accessed May 20, 2024."},{"key":"S1049023X25000251_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.auec.2022.05.002"},{"key":"S1049023X25000251_ref19","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000131439.87553.99"},{"key":"S1049023X25000251_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2019.06.005"},{"key":"S1049023X25000251_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00187-6"},{"key":"S1049023X25000251_ref5","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13814"},{"key":"S1049023X25000251_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-019-05918-1"},{"key":"S1049023X25000251_ref16","unstructured":"16. NSW Ambulance. Year-in-Review 2022\/2023. NSW Government. NSW Ambulance Web site. https:\/\/www.ambulance.nsw.gov.au\/__data\/assets\/pdf_file\/0006\/934665\/Year-in-Review-2022-2023.pdf. Accessed May 20, 2024."},{"key":"S1049023X25000251_ref2","doi-asserted-by":"crossref","first-page":"e316","DOI":"10.1016\/S2665-9913(23)00098-X","article-title":"Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021","volume":"5","author":"Ferreira","year":"2023","journal-title":"Lancet Rheumatol"},{"key":"S1049023X25000251_ref3","unstructured":"3. NHS England. Hospital Accident & Emergency Activity, 2022-2023. https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/hospital-accident--emergency-activity\/2022-23. England 2023. Accessed May 20, 2024."},{"key":"S1049023X25000251_ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2019-009383"},{"key":"S1049023X25000251_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.auec.2022.05.002"},{"key":"S1049023X25000251_ref13","doi-asserted-by":"publisher","DOI":"10.29045\/14784726.2022.03.6.4.11"},{"key":"S1049023X25000251_ref15","unstructured":"15. Australian Bureau of Statistics (September 2023). National, state, and territory population. ABS Web site. https:\/\/www.abs.gov.au\/. Accessed May 20, 2024."},{"key":"S1049023X25000251_ref20","doi-asserted-by":"publisher","DOI":"10.1002\/art.24853"},{"key":"S1049023X25000251_ref10","volume-title":"Characteristics of Operating Room Procedures in U.S. Hospitals, 2011. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs","author":"Weiss","year":"2006"},{"key":"S1049023X25000251_ref1","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1186\/s12891-017-1511-7","article-title":"Prevalence of low back pain in emergency settings: a systematic review and meta-analysis","volume":"18","author":"Edwards","year":"2017","journal-title":"BMC Musculoskelet Disord."},{"key":"S1049023X25000251_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2016.04.013"},{"key":"S1049023X25000251_ref9","doi-asserted-by":"publisher","DOI":"10.1111\/imj.14120"},{"key":"S1049023X25000251_ref14","unstructured":"14. L\u00f3pez Alonso, SR , Romero Cabrera, C , Mart\u00edn Caravantes, S , Rivero S\u00e1nchez, C , Mart\u00ednez Garc\u00eda, AI , Linares Rodr\u00edguez, C. Attention to lumbociatalgia by the emergency home nurse. Enfermer\u00eda Comunitaria. 2021;17. Available at: http:\/\/ciberindex.com\/c\/ec\/e13428. Accessed May 20, 2024."}],"container-title":["Prehospital and Disaster Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1049023X25000251","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T11:29:49Z","timestamp":1745407789000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1049023X25000251\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["S1049023X25000251"],"URL":"https:\/\/doi.org\/10.1017\/s1049023x25000251","relation":{},"ISSN":["1049-023X","1945-1938"],"issn-type":[{"value":"1049-023X","type":"print"},{"value":"1945-1938","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}